What does an Insurance Coordinator do?
An insurance coordinator is responsible for evaluating and validating insurance information to verify claims and process the necessary claims resolutions for parties. Insurance coordinators submit claims statements timely to the insurance officers for review, coordinate with the clients for inquiries and updates, and reach out to medical institutions for accurate filing of payments. An insurance coordinator must have excellent communication and analytical skills to assess reports, resolve claims discrepancies, and escalate high-level complaints to the officers for immediate action.
Insurance coordinator responsibilities
Here are examples of responsibilities from real insurance coordinator resumes:
- Verify patient dental insurance coverage and limitations with major private and business dental insurance providers as well as Medicaid and Medicare.
- File to record patient demographics in numerous EMR systems and paper charts if applicable.
- Prepare providers and staff for ICD-10 transition.
- Post and reconcile all daily insurance, patient payments and transactions within the EMR system.
- Experience in registration in healthcare, business office and physician billing, with reimbursement and collections.
- Process all Medicare claims, explaining HMO changes to patients in detail and accurately documenting all benefits.
- Verify ICD-9 codes and CPT billing codes to insure payment will be process for claim under customer's insurance plan.
- Code ICD-9 and CPT codes and post charges for both office visits and outpatient hospital procedures for the urology practice.
- Interact on a daily basis with doctors, nurses, and other healthcare professionals to insure accuracy and completion of billing.
- Maintain strictest confidentiality; adheres to all HIPAA guidelines/regulations.
- Submit appeals to Medicare, Medicaid and insurance companies for adjudication.
- Maintain HIPAA privacy laws by following guidelines accordingly when handling documents.
- Provide patients with all follow up appointment and documentation for insurance claims and policy information.
- Cultivate relationships with insurance representatives, physicians and patients to complete payment and accuracy of claims.
- Verify ICD9-ICD10 and HCPCS codes.
Insurance coordinator skills and personality traits
We calculated that 26% of Insurance Coordinators are proficient in Patients, Customer Service, and Insurance Verification. They’re also known for soft skills such as Math skills, Organizational skills, and Communication skills.
We break down the percentage of Insurance Coordinators that have these skills listed on their resume here:
- Patients, 26%
Assisted Office Manager with the daily administrative operations such as scheduling appointments and answering patients inquires.
- Customer Service, 11%
Provided quality customer service to insurance customers, including addressing all of their questions and concerns regarding their medical benefits.
- Insurance Verification, 7%
Obtain accurate data collection and entry, per appropriate and required demographics, financial, insurance verification and medical information.
- Insurance Eligibility, 4%
Verify patient insurance eligibility and benefits online and via telephone and notify patients of their financial responsibility prior to surgery.
- Medicaid, 3%
Run Weekly and Monthly Reports Verify Insurance via HIQA/Medicare/GHP For Medicaid and Commercial Insurance
- Medical Terminology, 3%
Perform excellent knowledge of insurance payers and medical terminology.
Common skills that an insurance coordinator uses to do their job include "patients," "customer service," and "insurance verification." You can find details on the most important insurance coordinator responsibilities below.
Math skills. To carry out their duties, the most important skill for an insurance coordinator to have is math skills. Their role and responsibilities require that "the job duties of financial clerks includes calculating charges and updating financial records." Insurance coordinators often use math skills in their day-to-day job, as shown by this real resume: "instituted use of excel spreadsheets to document and maintain monthly statistics subsequently incorporated into financial reports. "
Organizational skills. Another essential skill to perform insurance coordinator duties is organizational skills. Insurance coordinators responsibilities require that "financial clerks must be able to arrange files so they can find them quickly and efficiently." Insurance coordinators also use organizational skills in their role according to a real resume snippet: "key accomplishment: strengthened the previous billing process by developing an organizational system that enhanced office time management. "
Communication skills. Another skill that relates to the job responsibilities of insurance coordinators is communication skills. This skill is critical to many everyday insurance coordinator duties, as "financial clerks should be able to explain policies and procedures to colleagues and customers." This example from a resume shows how this skill is used: "coordinated/verified patient vision insurance benefits two weeks prior to date of service managed patients communications and order fulfillment"
The three companies that hire the most insurance coordinators are:
- Fresenius Medical Care North America Holdings Limited Partnership22 insurance coordinators jobs
- Fresenius Medical Care Windsor, LLC22 insurance coordinators jobs
- Robert Half5 insurance coordinators jobs
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Compare different insurance coordinators
Insurance coordinator vs. Scheduling coordinator
A scheduling coordinator is responsible for arranging the calendars and managing the appointments of a senior employee. Scheduling coordinators keep a record of meetings, reminding the key personnel as well as other participants of any schedule adjustments and cancellations. They are also responsible for booking venues for events and processing travel arrangements, following the specifications of the head personnel. A scheduling coordinator must be detail-oriented, as well as having excellent communication and organization skills to answer schedule queries and perform administrative tasks as needed.
These skill sets are where the common ground ends though. The responsibilities of an insurance coordinator are more likely to require skills like "strong customer service," "medicaid," "health insurance," and "medical billing." On the other hand, a job as a scheduling coordinator requires skills like "home health," "surgery," "phone calls," and "payroll." As you can see, what employees do in each career varies considerably.
Scheduling coordinators tend to make the most money working in the health care industry, where they earn an average salary of $35,624. In contrast, insurance coordinators make the biggest average salary, $33,609, in the pharmaceutical industry.On average, scheduling coordinators reach similar levels of education than insurance coordinators. Scheduling coordinators are 0.8% less likely to earn a Master's Degree and 0.2% less likely to graduate with a Doctoral Degree.Insurance coordinator vs. Medication coordinator
A medication care coordinator communicates on the job with basic knowledge of medical terminology and human anatomy to ensure that patient medication plans are correct. Medication care coordinators establish relationships with healthcare clinic partners. They serve as liaisons between pharmacies and patients. Their skills to acquire include knowledge and experience in patient care, customer service, medical standards, and treatment plans. They should also develop strong communication skills, attention to detail, and patient relations.
While some skills are similar in these professions, other skills aren't so similar. For example, resumes show us that insurance coordinator responsibilities requires skills like "strong customer service," "insurance eligibility," "health insurance," and "insurance benefits." But a medication coordinator might use other skills in their typical duties, such as, "triage," "test results," "vital signs," and "standing orders."
On average, medication coordinators earn a higher salary than insurance coordinators. Some industries support higher salaries in each profession. Interestingly enough, medication coordinators earn the most pay in the pharmaceutical industry with an average salary of $44,322. Whereas insurance coordinators have higher pay in the pharmaceutical industry, with an average salary of $33,609.medication coordinators earn similar levels of education than insurance coordinators in general. They're 4.7% more likely to graduate with a Master's Degree and 0.2% more likely to earn a Doctoral Degree.Insurance coordinator vs. Insurance specialist
An insurance specialist is an individual responsible for interpreting insurance plans and providing risk management advice to clients and wealth managers. Insurance specialists must have a full understanding of risk management to craft a comprehensive solution that integrates well with the client's portfolio. They need to manage their clients' accounts and should maintain contact with clients after the application process. Insurance specialists must ensure that government insurance programs comply with federal laws, regulations, and contracts within the healthcare industry.
There are many key differences between these two careers, including some of the skills required to perform responsibilities within each role. For example, an insurance coordinator is likely to be skilled in "strong customer service," "patient insurance," "diagnosis codes," and "patient care," while a typical insurance specialist is skilled in "exceptional client," "life insurance," "appeals," and "inbound calls."
Insurance specialists earn the highest salary when working in the government industry, where they receive an average salary of $38,343. Comparatively, insurance coordinators have the highest earning potential in the pharmaceutical industry, with an average salary of $33,609.insurance specialists typically earn similar educational levels compared to insurance coordinators. Specifically, they're 0.7% more likely to graduate with a Master's Degree, and 0.1% more likely to earn a Doctoral Degree.Insurance coordinator vs. Collections coordinator
Usually working alongside a company's account receivables team, a collections coordinator is in charge of developing strategies to optimize the payment collection operations. Among their responsibilities include reaching out to clients through calls or correspondence to remind them of their payment obligations, arranging appointments, processing payments, arranging payment terms, and researching a client's communication information such as cellphone number, address, or email. Moreover, a collections coordinator must maintain an active communication line with staff while promoting and enforcing the company's policies and regulations.
Types of insurance coordinator
Updated January 8, 2025
